Notice how Poe uses repetition to create intensity and build tension within the story. The narrator continuously insists that he is not mad; however, with this constant repetition, Poe creates a frenzied tone that suggests the narrator is less stable than he claims.
"I kept quite still and said nothing. For a whole hour I did not move a muscle, and in the meantime I did not hear him lie down. He was still sitting up in the bed listening;—just as I have done, night after night, hearkening to the death watches in the wall..."See in text(The Tell-Tale Heart)
Readers can relate to how the old man is feeling. Most readers have experienced lying in bed in a dark room and suddenly hearing a strange noise. They sit up and strain their ears to listen for a repetition of that sinister sound. Who knows what all those creaks and squeaks really are? Some of them might be mice. Or rats! Some might be the house itself settling just a fraction of an inch, or lumber stretching or contracting as the temperature changes. Or nails being pulled at by the lumber. Or bits of plaster falling from the musty lathing inside the walls. During such times, readers are acutely aware of their helplessness, unpreparedness, and vulnerability.